{
  "abstract": "Background Pain and fatigue are among the most debilitating symptoms of systemic sclerosis (SSc), severely impairing quality of life (QoL). Pharmacological management is often inadequate, and evidence on exercise is limited. This study aimed to evaluate the effects of a tailored exercise programme on pain and fatigue in people with SSc (PwSSc).Methods This European multicentre randomised controlled trial (n=6) recruited 170 PwSSc (89% limited cutaneous SSc), randomised to an exercise intervention group (EIG) or usual care group (UCG). The EIG completed a 12-week, twice-weekly supervised programme combining 30 min of high-intensity interval training (HIIT) and 15 min of resistance training (RT), in addition to usual care. The UCG received usual care alone. Outcomes were assessed at baseline, 12 weeks (primary endpoint) and 24 weeks, with pain and fatigue as primary outcomes, and QoL, depression, functional ability, musculoskeletal strength/endurance and cardiorespiratory fitness as secondary outcomes.Results At 12 weeks, the mean group differences for the primary, fatigue (−10.4 (95% CI 19.4 to −1.4), p<0.05) and pain (0.48 (95% CI 0.21 to 0.76), p<0.05), secondary, depression (p<0.001), QoL and self-reported function (p<0.05) and exploratory outcomes musculoskeletal strength and endurance (p<0.01), and cardiorespiratory fitness (p<0.001) were significantly improved in EIG compared with UCG.Conclusions A 12-week supervised combined upper body exercise programme can improve pain, fatigue, depression, QoL, function, strength and cardiorespiratory fitness in PwSSc. HIIT combined with RT is safe for the study population and may serve as an effective non-pharmacological adjunct to pharmacotherapy to manage SSc symptoms and enhance QoL.Trial registration number NCT05234671.",
  "authors": [
    {
      "affiliations": [
        "Lifestyle Exercise and Nutritional Improvement (LENI) Research Group, Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK"
      ],
      "name": "Alexandros Mitropoulos"
    },
    {
      "affiliations": [
        "Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark"
      ],
      "name": "Kasper Yde Jensen"
    },
    {
      "affiliations": [
        "Laboratory of Sports Medicine, Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Evangelia Kouidi"
    },
    {
      "affiliations": [
        "Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Carina Boström"
    },
    {
      "affiliations": [
        "Department of Precision Medicine, Universita degli Studi della Campania Luigi Vanvitelli, Naples, Italy"
      ],
      "name": "Giovanna Cuomo"
    },
    {
      "affiliations": [
        "Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark"
      ],
      "name": "Louise Pyndt Diederichsen"
    },
    {
      "affiliations": [
        "Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden",
        "Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden"
      ],
      "name": "Malin Mattsson"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Eva M Hoekstra"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Jeska De Vries-Bouwstra"
    },
    {
      "affiliations": [
        "4th Department of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece"
      ],
      "name": "Theodoros Dimitroulas"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"
      ],
      "name": "Mohammed Akil"
    },
    {
      "affiliations": [
        "Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark"
      ],
      "name": "Søren Jacobsen"
    },
    {
      "affiliations": [
        "Lifestyle Exercise and Nutritional Improvement (LENI) Research Group, Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK"
      ],
      "name": "Markos Klonizakis"
    },
    {
      "affiliations": [],
      "name": "IMPACT-SSc CONSORTIUM"
    }
  ],
  "title": "High-intensity interval and resistance training programme improves pain and fatigue outcomes in people with systemic sclerosis: a European multicentre randomised controlled trial",
  "uid": "a542a7e8-3773-5985-af91-a3f249573139"
}